细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析

姬忠贺; 梁寒; 季加孚; 于洋; 李鑫宝; 李雁

doi:10.3971/j.issn.1000-8578.2017.17.0563

细胞减灭术加腹腔热灌注化疗治疗胃癌腹膜癌的系统分析

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Gastric Cancer Peritoneal Carcinomatosis: A Systemic Analysis

摘要

摘要:
目的系统分析肿瘤细胞减灭术（cytoreductive surgery, CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy, HIPEC）治疗胃癌腹膜癌（gastric cancer peritoneal carcinomatosis, GC PC）的应用现状及发展方向。
方法检索CRS+HIPEC治疗GC PC相关临床研究文献，提取生存及安全性相关数据，进行系统分析。
结果 GC PC的自然病程不超过5月，CRS+HIPEC可延长GC PC患者总生存期（overall survival, OS）。在前瞻性临床研究中CRS+HIPEC组中位OS为11.0月，在回顾性临床研究中CRS+HIPEC组中位OS为13.3月。CRS+HIPEC治疗GC PC围手术期死亡率低于6.5%，严重不良事件发生率无显著上升。
结论 CRS+HIPEC治疗GC PC疗效显著，有望成为部分经选择的GC PC患者的首选治疗。

Abstract:
Objective To evaluate the clinical trials of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on gastric cancer peritoneal carcinomatosis (GC PC).
Methods The published clinical trials of CRS+HIPEC on GC PC were critically evaluated, with survival and safety as the primary endpoints.
Results The natural course of GC PC was < 5 months. CRS+HIPEC could improve the overall survival (OS). In prospective studies, the median OS was 11.0 months in the CRS+HIPEC group. In retrospective studies, the median OS was 13.3 months in the CRS+HIPEC group. The perioperative mortality was less than 6.5%, and there was no statistically significant increase in serious adverse events directly attributable to CRS+HIPEC.
Conclusion CRS+HIPEC is a promising integrated treatment strategy for GC PC to produce improved treatment efficacy, and should be recommended as the first treatment choice for selected patients with GC PC.

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